Background/aims: This study assesses and compares prevalence of psychological and behavioral symptoms in a Belgian sample of people with and without dementia. Methods: A total of 228 persons older than 65 ... [more ▼]

Background/aims: This study assesses and compares prevalence of psychological and behavioral symptoms in a Belgian sample of people with and without dementia. Methods: A total of 228 persons older than 65 years with dementia and a group of 64 non- demented persons were assessed using the Neuropsychiatric Inventory (NPI) in 2004. Results: Within the group without dementia, the most frequent symptoms were depression, agitation, and irritability. Within the group with dementia, the most common symptoms were depression, irritability, apathy, and agitation. Prevalence of delusions (P [less ▲]

The aim of this descriptive study was to estimate and compare the association between cognitive decline and quality of life (QOL) for 2 groups of dementia patients differing by place of residence: home or ... [more ▼]

The aim of this descriptive study was to estimate and compare the association between cognitive decline and quality of life (QOL) for 2 groups of dementia patients differing by place of residence: home or institution. Each subject was placed within a specific subgroup according to their Mini-Mental State Examination (MMSE) score and was evaluated by a QOL proxy-assessment [Alzheimer Disease Related Quality of Life (ADRQL)] and a dependency assessment (Katz Activities of Daily Living classification). For the ‘‘at home’’ and ‘‘institution’’ groups, global and subscale ADRQL scores showed significant differences between the 5 MMSE subgroups. Place of residence and MMSE subgroups significantly affected global and subscale ADRQL scores. The MMSE 4 to 8, 9 to 13, and 14 to 18 subgroups had ADRQL global scores significantly better in the institution group than the at home group. In contrast, the MMSE 19 to 23 and 0 to 3 subgroups had similar ADRQL global scores in both places of residence. In conclusion, there is no direct relationship between cognitive decline and QOL, and QOL does not seem to be better at home compared with the institution. [less ▲]

Behavioural and psychological signs and symptoms - BPSD are clinical features of dementia. They have considerable impact on the daily life of patients and their caregivers. The aim of this study is to ... [more ▼]

Behavioural and psychological signs and symptoms - BPSD are clinical features of dementia. They have considerable impact on the daily life of patients and their caregivers. The aim of this study is to show the importance of these disorders in dementia semiology and to assess differences in their prevalence across levels of severity of dementia. The sample is made up of 160 subjects with dementia older than 65 years old. Diagnosis of dementia was based on DSM-IV criteria. BPSD were assessed with the NeuroPsychiatric Inventory-NPI and dementia staging was measured with Clinical Dementia Rating/Modified-CDR-M. Results show that prevalence of delusions is more important in severe dementia and that prevalence of agitation/ aggression is more important in profound dementia. These data may help to clarify objectives and treatment of BPSD. This study raises also some methodological problems with the NPI and underlines the importance to define the different disorders included in certain NPI domains accurately. [less ▲]

OBJECTIVES: To assess the sensitivity of the 'Alzheimer's Disease Related Quality of Life' instrument (ADRQL) applied to Belgian people with dementia (n = 357), mild cognitive impairment (MCI) (n = 36), and controls (n = 72). We also determined the clinical parameters that influence the quality of life (QOL) of people with dementia. METHOD: Each subject was evaluated with the ADRQL, the Mini Mental State Examination (MMSE), the cognitive scale of the Cambridge Examination for Mental Disorders of the Elderly (CAMCOG), the Katz's ADL classification (ADL), the Instrumental Activities of Daily Living (IADL), the Behavior Rating Scale for Dementia (CERAD/BRSD), and the Clinical Dementia Rating/Modified (CDR-M). RESULTS: The ADRQL showed that QOL of the dementia group (65.77 +/- 17.04) was significantly inferior to that of the MCI (82.11 +/- 13.31) and control groups (79.75 +/- 15.82). There were no significant differences between the MCI and control groups. Within the dementia group, the five ADRQL subscale results were similar to those reported in other studies. Gender, age and place of residence had no significant influence on ADRQL scores. In contrast, ADRQL scores correlated significantly with MMSE, CAMCOG, IADL, ADL, CERAD/BRSD, and CDR-M. The MMSE and CERAD/BRSD were significant predictors of ADRQL variability. CONCLUSIONS: QOL of people with dementia is inferior to that of people with MCI and controls. This demonstrates the ADRQL instrument is sufficiently sensitive for evaluating the QOL of people with dementia. Longitudinal studies are needed to specifically examine the rate of QOL evolution throughout the entire dementia process. Copyright (c) 2008 John Wiley [less ▲]

Aims: We aimed to examine the association of cognitive decline with quality of life (QoL) in dementia compared to controls and to determine variables associated with QoL. Methods: Every subject was placed ... [more ▼]

Aims: We aimed to examine the association of cognitive decline with quality of life (QoL) in dementia compared to controls and to determine variables associated with QoL. Methods: Every subject was placed within a specific group depending on their designation by the Mini Mental State Examination and evaluated by the Alzheimer’s Disease Related Quality of Life (ADRQL) and clinical assessments. Results: QoL for the mild dementia group was lower (p = 0.08) than that of controls. The very severe dementia group had a significantly lower QoL than the other dementia groups, which all had similar ADRQL scores. The only predictor of ADRQL scores was found to be the behavioral and psychological symptoms of dementia. Conclusion: There is no direct relationship between cognitive decline and QoL. [less ▲]

in International Journal of Geriatric Psychiatry (2007), 22(12), 1201-1207

Objectives To examine the evolution of quality of life (QOL) in demented subjects at base-line, one and 2 years later and to determine clinical variables associated with QOL. Method Longitudinal study of ... [more ▼]

Objectives To examine the evolution of quality of life (QOL) in demented subjects at base-line, one and 2 years later and to determine clinical variables associated with QOL. Method Longitudinal study of a cohort of 127 subjects living at home or in a long-term care institution. A QOL measure (Alzheimer Disease Related Quality of Life; ADRQL) was administered three times. In addition, several clinical instruments (MMSE, IADL, ADL and CDR/M) were also administered. Results ADRQL data analysis did not reveal significant modifications of QOL over the 2-year period, whereas results from clinical instruments showed a significant deterioration. On the group, the variations of ADRQL scores were limited, with some improvement after the first year followed by some deterioration after the second year. On the other hand, ADRQL scores fluctuated every year by at least 10 points for more than 50% of subjects. With dementia evolution, it was observed that the clinical variables were more strongly correlated with ADRQL scores and were more significant predictors. This varied from 5.9% (MMSE) in 2002 to 40.01 % in 2004 (MMSE and CDR/M). Conclusions QOL did not develop in a strictly linear manner following the deterioration of clinical state. This suggests that the evolution of QOL is also determined by other variables relating to the physical and social environment of the patients. Their role seems particularly important for the mild to moderate stages of dementia. Copyright (c) 2007 John Wiley [less ▲]

BACKGROUND. Although patients with cancer are often accompanied by a relative during medical interviews, to the authors' knowledge little is known regarding the efficacy of communication skills training ... [more ▼]

BACKGROUND. Although patients with cancer are often accompanied by a relative during medical interviews, to the authors' knowledge little is known regarding the efficacy of communication skills training programs on physicians' communication skills in this context. The objective of the current study was to assess the efficacy of 6 consolidation workshops, 3 hours in length, that were conducted after a 2.5-day basic training program. METHODS. After attending the basic training program, physicians were assigned randomly to consolidation workshops or to a waiting list. Training efficacy was assessed through simulated and actual interviews that were recorded on an audio tape at baseline, after consolidation workshops for the consolidation-workshops group, and 5 months after the end of basic training for the waiting-list group. Communication skills were assessed according to the Cancer Research Campaign Workshop Evaluation Manual. Patients' and relatives' perceptions of and satisfaction with physicians' communication performance were assessed using a 15-item questionnaire. RESULTS. Sixty-two physicians completed the training program. Compared with physicians who participated to the basic training program, when addressing the patient, physicians who were randomized to the consolidation workshops used more open, open directive, and screening questions (P = 0.011 in simulated patient interviews and P = 0.005 in actual patient interviews) and elicited and clarified psychologic concerns more often (P = 0.006 in simulated patient interviews and P < 0.001 in actual patient interviews). When they addressed the relative, physicians who were randomized to the consolidation workshops gave less premature information (P = 0.032 in simulated patient interviews and P < 0.001 in actual patient interviews). When they addressed the patient and the relative simultaneously, physicians who were randomized to the consolidation workshops used more empathy, educated guesses, alerting to reality, confronting, negotiating, and summarizing (P = 0.003 in simulated patient interviews and P = 0.024 in actual patient interviews). Patients, but not relatives, who interacted with physicians in the consolidation-workshops group were more satisfied globally with the interviews (P = 0.022). CONCLUSIONS. Six 3-hour consolidation workshops resulted in improved communication skills addressed to patients and to relatives. The current results showed that the transfer of skills addressing relatives' concerns remained limited and that consolidation workshops should focus even more systematically on the practice of three-person interviews. (c) 2005 American Cancer Society. [less ▲]

Purpose: Although there is wide recognition of the usefulness of improving physicians' communication skills, no studies have yet assessed the efficacy of post-training consolidation workshops. This study ... [more ▼]

Purpose: Although there is wide recognition of the usefulness of improving physicians' communication skills, no studies have yet assessed the efficacy of post-training consolidation workshops. This study aims to assess the efficacy of six 3-hour consolidation workshops conducted after a 2.5-day basic training program. Methods: Physicians, after attending the basic training program, were randomly assigned to consolidation workshops or to a waiting list. Training efficacy was assessed through simulated and actual patient interviews that were audiotaped at baseline and after consolidation workshops for the consolidation-workshop group, and approximately 5 months after the end of basic training for the waiting-list group. Communication skills were assessed according to the Cancer Research Campaign Workshop Evaluation Manual. Patients' perceptions of communication skills improvement were assessed using a 14-item questionnaire. Results : Sixty-three physicians completed the training program. Communication skills improved significantly more in the consolidation-workshop group compared with the waiting-list group. In simulated interviews, group-by-time repeated measures analysis of variance showed a significant increase in open and open directive questions (P =.014) and utterances alerting patients to reality (P =.049), as well as a significant decrease in premature reassurance (P =.042). In actual patient interviews, results revealed a significant increase in acknowledgments (P =.022) and empathic statements (P =.009), in educated guesses (P =.041), and in negotiations (P =.008). Patients interacting with physicians who benefited from consolidation workshops reported higher scores concerning their physicians' understanding of their disease (P =.004). Conclusion: Consolidation workshops further improve a communication skills training program's efficacy and facilitate the transfer of acquired skills to clinical practice. [less ▲]

This study assesses the relationship between the Sense of Coherence (SoC) of Antonovsky, anger and the obsessive-compulsive disorder. The sample is composed of 42 subjects divided in two groups, 21 ... [more ▼]

This study assesses the relationship between the Sense of Coherence (SoC) of Antonovsky, anger and the obsessive-compulsive disorder. The sample is composed of 42 subjects divided in two groups, 21 subjects suffering of obsessive-compulsive disorder and 21 subjects matched controls. They completed a demographic questionnaire, the list of obsessions and compulsions of Goodman & al.(1989), translation Mollard, Cottraux & Bouvard (1989), the Visual Analogues Scales, the Orientation Life Questionnaire of Antonovsky (1987), the State-Trait Anger Expression Inventory of Spielberger (STAXI), the State-Trait Anxiety Inventory of Spielberger (STAI), and the Beck Depression Inventory (BDI). The results show higher scores of anxiety and depression in obsessive-compulsive patients than in controls subjects. According to the results obtained with the Anger Inventory, the obsessive-compulsive subjects show higher scores of state-anger, of anger-expression and higher scores of anger-control. The results of the Sense of Coherence scale reveal a lower SoC in TOC group than in control group. The SoC is also negatively associated with depression and anxiety in both groups. The SoC is negatively associated with the control of anger in the TOC group and with the suppression of anger in the control group. The theorical and clinical implications of these results are discussed. [less ▲]

The aim of this study was to measure the quality of life of coronary artery bypass surgery patients enrolled or not in a rehabilitation program. The study was prospective and longitudinal and used ... [more ▼]

The aim of this study was to measure the quality of life of coronary artery bypass surgery patients enrolled or not in a rehabilitation program. The study was prospective and longitudinal and used patients’ self selection as the allocation strategy to constitute the two groups: rehabilitation and no-rehabilitation. Forty first coronary bypass surgery patients (38 men and 2 women, mean age 59 +/-8) were recruited from four hospitals in a French area of Belgium. Patients were evaluated before and after surgery with: the Quality of Life Systemic Inventory (QLSI), the Beck Depression Inventory, the State Anxiety Inventory, a somatic symptoms questionnaire, a physical activities questionnaire, and a medical questionnaire. Both groups improved on the QLSI global score of quality of life, but the effect size (eta squared) was greater in the rehab group (0.5) compared to the no rehab group (0.25) [less ▲]